HF 4142

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/12/2026 04:46 p.m.

A bill for an act
relating to human services; prohibiting medical assistance coverage of prescription
drugs solely for weight loss; amending Minnesota Statutes 2025 Supplement,
section 256B.0625, subdivision 13d.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 13d, is
amended to read:

Subd. 13d.

Drug formulary.

(a) The commissioner shall establish a drug formulary. Its
establishment and publication shall not be subject to the requirements of the Administrative
Procedure Act, but the Formulary Committee shall review and comment on the formulary
contents.

(b) The formulary shall not include:

(1) drugs, active pharmaceutical ingredients, or products for which there is no federal
funding;

(2) over-the-counter drugs, except as provided in subdivision 13;

(3) drugs or active pharmaceutical ingredients when used for the treatment of impotence
or erectile dysfunction;

(4) drugs or active pharmaceutical ingredients for which medical value has not been
established;

(5) drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act; deleted text begin and
deleted text end

new text begin (6) drugs or active pharmaceutical ingredients when used only for weight loss; and
new text end

deleted text begin (6) deleted text end new text begin (7) new text end medical cannabis flower as defined in section 342.01, subdivision 54, or medical
cannabinoid products as defined in section 342.01, subdivision 52.

(c) If a single-source drug used by at least two percent of the fee-for-service medical
assistance recipients is removed from the formulary due to the failure of the manufacturer
to sign a rebate agreement with the Department of Health and Human Services, the
commissioner shall notify prescribing practitioners within 30 days of receiving notification
from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was
not signed.

(d) Within ten calendar days of any commissioner determination to change the drug
formulary, the commissioner must provide written notice to all enrollees, prescribers, and
pharmacists affected by the change. The notice must include a description of the change,
the reason for the change, and the date the change will become effective.

(e) By January 15, 2026, and annually thereafter, the commissioner of human services
must provide a report with data and information related to the effects on enrollees of drug
formulary changes made in the prior calendar year to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance. The report must include but is not limited to data and information on:

(1) the number of times the formulary was changed;

(2) the reasons for the formulary changes and how frequently the formulary was changed
for each reason;

(3) the drugs that were removed from the formulary;

(4) for each drug that was removed from the formulary, the number of enrollees who
were prescribed that drug when it was removed;

(5) for each drug that was removed from the formulary, whether a therapeutically
equivalent drug was added;

(6) the drugs that were added to the formulary;

(7) the fiscal impacts to the Department of Human Services resulting from the changes
to the formulary; and

(8) enrollee populations or medical conditions disproportionately affected by the
formulary changes.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027, or upon federal approval,
whichever is later.
new text end